Abstract THE ENCOURAGING results of recent operations designed to relieve portal hypertension have brought renewed interest in the nature of varices of the esophagus. It is generally assumed that these lesions, often fatal because of massive bleeding from them, are secondary to increased pressure within the portal system of veins. In the great majority of patients, this is true. Occasionally, however, esophageal varices are found in the absence of portal hypertension, and for these persons operations designed to correct increased portal venous pressure would be ill-advised. The problem is illustrated by a patient recently studied at City Hospital, Cleveland. REPORT OF A CASE J. B., a 42-year-old white man, was admitted to City Hospital on Jan. 15, 1951, because of severe frostbite of both feet following six days of exposure to freezing weather. The patient had been in good health in the past but admitted a poor dietary intake and chronic References 1. Higgins, W.: The Esophageal Varix: A Report of 115 Cases , Am. J. M. Sc. 214:436, 1947.Crossref 2. Linton, R.; Hardy, I., and Volwiler, W.: Porta Caval Shunts in the Treatment of Portal Hypertension , Surg., Gynec. & Obst. 87:129, 1948. 3. Gray, H. K., and Whitesell, F. B., Jr.: Hemorrhage from Esophageal Varices: Surgical Management , Ann. Surg. 132:798, 1950. 4. Nochimowski, J.: Fatal Hemorrhages from Varices of Esophagus in Cases Without Cirrhosis of the Liver , Ztschr. Path. 43:463, 1932 5. abstracted, J. A. M. A. 99:1643, 1932. 6. Friedman, E.: Esophageal Varix: Report of Case in a 3½ Year Old Child, Not Dependent on Liver Cirrhosis , J. Pediat. 4:641, 1934. 7. Lichtman, S.: Diseases of the Liver , Gall Bladder and Bile Ducts, Philadelphia, Lea & Febiger, 1942. 8. A Textbook of Pathology , edited by E. Bell, Philadelphia, Lea & Febiger, 1947. 9. Weinberg, T.: Observations on the Occurrence of Varices of the Esophagus in Routine Autopsy Material , Am. J. Clin. Path. 19:554, 1949. 10. Welch, C.: Portal Hypertension , New England J. Med. 243: 598, 1950. 11. Maxwell, M. H.; Breed, E., and Schwartz, I. L.: Renal Venous Pressure in Chronic Congestive Heart Failure , J. Clin. Invest. 29:342, 1950. 12. Higgins.1 Lichtman.6
A.M.A. Archives Surgery – American Medical Association
Published: Sep 1, 1952
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